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Background: People are aware of the consequences of high serum lipid levels, specifically, total cholesterol. Awareness about harmful effects of very low levels of serum lipids is still lacking. Very low levels of serum lipids lead to psychological consequences.

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Background and AimProgression of liver disease in cirrhosis is associated with an increased incidence of portal vein thrombosis (PVT) in cirrhosis. However, evidence suggests that spontaneous recanalization of PVT may occur even without anti‐thrombotic therapy. Thus, the present meta‐analysis was conducted to study the natural history of PVT in cirrhosis, facilitating decisions regarding anticoagulation.MethodsThree electronic databases were searched from 2000 to August 2022 for studies reporting the outcome of PVT in cirrhotics without anticoagulation. The pooled proportions with their 95% confidence intervals (CIs) were calculated using a random‐effect model.ResultsA total of 26 studies (n = 1441) were included in the final analysis. Progression of PVT on follow‐up was seen in 22.2% (95% CI 16.1–28.4), while 77.7% (95% CI 71.6–83.9) remained non‐progressive (improved or stable). The most common outcome was a stable PVT with a pooled event rate of 44.6% (95% CI 34.4–54.7). The pooled rates of regression and complete recanalization of PVT in cirrhotics were 29.3% (95% CI 20.9–37.7) and 10.4% (95% CI 5.0–15.8), respectively. On follow‐up after improvement, pooled recurrence rate of PVT was 24.0% (95% CI 14.7–33.4). MELD score, and presence of ascites had a negative association, while a longer follow‐up duration had positive association with PVT regression.ConclusionApproximately 25% of the cases of PVT in cirrhosis are progressive, 30% cases improve, and 45% remain stable. Future studies are needed to analyze the predictors of spontaneous regression.

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Background and Aim The COVID pandemic and countrywide lockdown has had significant impact on patients with inflammatory bowel disease (IBD), with delay in diagnosis, difficulty in access to healthcare and unavailability of drugs. We conducted a telephonic survey to assess this impact. Methods Out of 350, 302 participated in the survey. Demographic data, disease severity at the time of survey, extent of disease, details of therapy, and adherence were noted. A validated questionnaire addressing information source, perception of COVID‐19 situation, contact with healthcare, and adherence to standard precautions was administered telephonically. Results Out of 350 contacted patients, 302 (86.28%) patients participated in the survey. Median age of cohort was 39 years. Ulcerative colitis (UC) constituted 79%, 16% Crohn's disease (CD), and 5% IBD‐unclassified. At the time of survey, 86.98% patients with UC were in clinical remission and 75.75% of CD patients were generally well. A total of 115 (38%) cases were nonadherent to therapy due to unavailability of medicines (66.38%), financial constraints (25.21%) and inability to reach healthcare facility (3.6%). Disease flare was seen in 14.2% and correlated well with nonadherence. Existing drug therapy was switched to alternative drug in 70 (23.17%) cases due to unavailability (74%). Social media (52.3%) and television (40.4%) were the common sources of information about the pandemic. Telemedicine platforms (WhatsApp and telephone) were used by 180 (59.6%) patients for consultation with good acceptance (81.6%). 87 (28.8%) patients failed to contact healthcare. Apprehension regarding severe COVID infection was noted in 80% while 29% thought that IBD therapy could increase infection risk. Adherence to wearing mask, hand washing, and social distancing was 100%. Conclusion Pandemic resulted in disruption of healthcare visits and medication supply. Majority were concerned about increased risk of COVID‐19 infection and adhered to standard precautions. Mobile phone‐based formats for patient care may be an alternative due to patient acceptance and convenience.

prevalent in the West, there has been an increasing incidence in Asian countries in the last two decades. 2,3 The treatment of IBD primarily involves immunosuppressive and immunomodulatory drugs. This not only increases the chance of prevalence of various chronic infective diseases like chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) but also may lead to reactivation of the latter disease. [4][5][6] This will have more impact on Asian countries due to the moderately high prevalence of HBV infection. 7 Therefore, screening for chronic HBV and HCV is crucial before starting the immunosuppressive treatment in IBD. Nonalcoholic fatty liver disease is becoming more com-